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Mechanical Circulatory Assist Devices as a Bridge to Heart Transplantation or as “Destination Therapy“: Options for Patients in Advanced Heart Failure

Writer and Curator: Larry H. Bernstein, MD, FCAP

and

Curator: Aviva Lev-Ari, PhD, RN 

UPDATED on 10/22/2018

“When heart failure (HF) progresses to an advanced stage, difficult decisions must be made,” the AHA says on its website. “Do I want to receive aggressive treatment? Is quality of life more important than living as long as possible? How do I feel about resuscitation?”

LVADs can take over the pumping function of a failing heart, but they also present some of the most expensive implantable-device surgeries. An article in the peer-reviewed journal JACC: Heart Failure reported last year that the average total cost to implant an LVAD in Medicare beneficiaries was $175,000, more than double the cost of a heart transplant.

Amador said between 5,000 and 5,500 Americans will have LVAD implants this year. That compares with 2,200 adult heart transplants that happen annually in the U.S., according to the JACC article.

Starling RC.
Cleve Clin J Med. 2013 Jan; 80(1):33-40. http://dx.doi.org/10.3949/ccjm.80gr.12003

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Implantable Synchronized Cardiac Assist Device Designed for Heart Remodeling: Abiomed’s Symphony

Aviva Lev-Ari, PhD, RN

http://pharmaceuticalintelligence.com/2012/07/11/implantable-synchronized-cardiac-assist-device-designed-for-heart-remodeling-abiomeds-symphony/

What is Acute Heart Failure? (Photo credit: Novartis AG)

English: The CardioWest™ temporary Total Artificial Heart (Photo credit: Wikipedia)

English: Graph showing the correlation between BNP serum level and mortality. Source: Inder S. Anand, Lloyd D. Fisher, Yann-Tong Chiang, Roberto Latini, Serge Masson,Aldo P. Maggioni, Robert D. Glazer, Gianni Tognoni, Jay N. Cohn (24th Feb 2003). Changes in Brain Natriuretic Peptide and Norepinephrine Over Time and Mortality and Morbidity in the Valsartan Heart Failure Trial (Val-HeFT). Circulation 107: 1278-83. DOI: 10.1161/01.CIR.0000054164.99881.00 (Photo credit: Wikipedia)